title: Predictors of continued HIV-risk behaviors among drug users in methadone maintenance therapy program in China--a prospective study.
abstract: BACKGROUND
  To examine the predictors of continued drug- and sex-related HIV-risk behaviors among drug users in methadone maintenance therapy (MMT) programs in China.
  
  
  METHODS
  We followed a sample of 5,035 drug users enrolled for the first time in MMT programs at baseline, 6 months, and 12 months utilizing a longitudinal prospective study design. Drug users' HIV-risk behaviors, MMT characteristics, and drug use, were assessed at all three waves using a structured interview and HIV/HCV status was assessed at baseline and 12-month follow-up using biological specimens.
  
  
  RESULTS
  The point prevalence of HIV was 7.6% and 78.4% for HCV at baseline. Results of generalized linear mixed logistic regression models revealed that HIV-positive MMT clients were more likely to engage in drug injection (aOR = 1.70) and syringe sharing (aOR = 4.73). HCV-positive clients were more likely to inject drugs (aOR = 2.58), share syringes (aOR = 1.97), and have multiple sexual partners (aOR = 1.47). Adherence to MMT was the most significant predictor of reduced HIV-risk behaviors.
  
  
  CONCLUSIONS
  Our data confirmed the positive effects of MMT on HIV prevention and underscored the urgency for programs to reduce HIV risk in HIV- and HCV-positive clients. There is a pressing need to strengthen existing counseling services for HIV-positive drug users to reduce their drug-related risk behaviors and to provide counseling for HCV-positive drug users. Further studies are needed to explore interventions to address high dropout rates and low adherence among MMT clients.
authors.affiliation: Faculty of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, #74, Zhongshan Road II, Guangzhou 510080, P,R China. lingli@mail.sysu.edu.cn.
authors.forename: Wen
authors.initials: W
authors.lastname: Chen
authors.forename: Yinghua
authors.initials: Y
authors.lastname: Xia
authors.forename: Yan
authors.initials: Y
authors.lastname: Hong
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Hall
authors.forename: Li
authors.initials: L
authors.lastname: Ling
mesh_terms: D000328:Adult; D002681:China; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000523:psychology*; D019698:Hepatitis C, Chronic / Q000150:complications / Q000534:rehabilitation; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008691:Methadone / Q000627:therapeutic use*; D009294:Narcotics / Q000627:therapeutic use*; D058850:Opiate Substitution Treatment / Q000523:psychology; D009293:Opioid-Related Disorders / Q000150:complications / Q000523:psychology / Q000534:rehabilitation*; D011446:Prospective Studies; D012309:Risk-Taking; D012747:Sexual Partners; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000523:psychology / Q000534:rehabilitation*; D047568:Unsafe Sex / Q000523:psychology / Q000706:statistics & numerical data
chemical_list: D009294:Narcotics; D008691:Methadone